Since 2004, natural disasters with death tolls in the tens of thousands have struck in 6 countries across the globe. Little evidence exists on the longer-term consequences of these large-scale disasters on the health and well-being of older adults. Yet, the consequences have potentially devastating implications for older adults whose health is typically in decline, for whom loss of assets and family often means loss of future economic support and who have less time to rebuild their lives than their younger counterparts. This project will examine the longer-term consequences of the 2004 Indian Ocean tsunami on the health and well-being of older adults who were living in coastal areas of Aceh and North Sumatra, Indonesia, at the time of the tsunami. The Indian Ocean tsunami was an unanticipated, massive natural disaster spawned by an earthquake in an area that had not experienced a tsunami for 600 years. It killed over 160, 000 Indonesians. Building on a pre-tsunami population-representative baseline, we have tracked and re-interviewed almost 30,000 tsunami survivors annually for 5 years. This continuation project will re-interview older adults and their families 8 and 10 years after the tsunami. These uniquely rich data will be analyzed to investigate the longer-term consequences of the tsunami, and its aftermath, for mortality, psycho-social, physical and biological markers of the health of older adults as well as the longer-term impacts of the tsunami on an array of indicators of social and economic status. Some older adults display remarkable resilience in the face of adversity. The research will identify the socio-economic and demographic characteristics associated with greater resilience in each of the domains of health and well-being. To provide insights into underlying biological mechanisms, we will investigate hypothesized gene-environment interactions that are thought to affect health outcomes and examine how environmental and psychological factors influence gene expression. Community level measures of tsunami damage based on high resolution satellite imagery of each of our study sites will provide indicators of plausibly exogenous exposure to the tsunami. These measures will be complemented with individual-specific experiences of the horror of the tsunami as well as loss of family members and economic assets. The Study of the Tsunami Aftermath and Recovery (STAR) data that will be collected and analyzed in this project will be placed in the public domain to provide an extremely rich resource for policy and science.